Missouri’s business community is getting more vocal in pushing the state’s legislators to expand Medicaid.

The St. Louis Regional Chamber held a panel Friday with business leaders who expressed frustration that the state is not capturing federal dollars to provide Medicaid coverage to more low-income residents.

This year, the state will pass up $2 billion dollars in federal funds.

After the panel discussion, St. Louis Regional Chamber President and CEO Joe Reagan said that Jefferson City needs to get the message.

For years in most states, Medicaid eligibility had been limited to disabled adults, seniors needing long-term care and very low-income parents with their children.

Then along came the Affordable Care Act. It was designed to grow health insurance coverage across the board. One of its tenets was to expand Medicaid coverage beyond the extremely poor and disabled to include all adults earning up to 138 percent of federal poverty levels.

But in 2012, the Supreme Court gave states the chance to opt out Medicaid expansion.

He woke up in the middle of the night late last year, one hand swollen and the rest of his body was shaking all over.

John Redford realized the symptoms were the consequences of several bites and scratches the day before from his struggle to put the family's 40-pound cat into a cage. He managed to calm himself enough that night and drive an old Mustang 50 miles to a hospital emergency room in Jefferson City. There doctors began weeks of treatment and ultimately saved Redford from losing a finger.

Former U.S. Sen.Kit Bond paid a visit to Jefferson City Tuesday, hoping to persuade his fellow Republicans in the Missouri House and Senate to expand Medicaid coverage to more people.

Bond told a gathering of Missouri Chamber of Commerce and Industry members that he doesn't like Obamacare, and he called its rollout a "disaster." But he also said that accepting federal dollars to expand Medicaid could enable Missouri to craft its own health-care solution.

U.S. Health and Human Services Secretary Kathleen Sebelius tried to put a price tag and a face on the government’s health reform push in Missouri when she visited the Grace Hill Water Tower Health Center on Friday.

The price tag: $5 million a day. That’s how much she says Missouri is losing by refusing to expand its Medicaid program under the Affordable Care Act.

The face: a local resident who praised the law for the help it is providing his family while he attends law school.

The state of Missouri recovered more than $47 million in fraudulent claims made by Medicaid providers in 2013.

That's about an average year for Attorney General Chris Koster's Medicaid Fraud Unit. The office has recovered as much as $100 million, and as little as $20 million, in a year.

Koster, a Democrat, says those wide variations are triggered by how much money Missouri receives from national settlements. But even though more national settlements means more money for the state's coffers, he says the fraud that concerns him the most is conducted by the smaller providers.

On this week’s podcast, Jason and Jo discuss the roadblocks to getting “right to work” on the ballot and why upcoming campaign finance reports matter. For the rest of the show, the Politically Speaking crew talks with Rep. Jay Barnes, R-Jefferson City.

During the show, Barnes described his proposal to expand Medicaid – which some see as an alternative to the straight-up Medicaid expansion that Gov. Jay Nixon supports. Barnes also discussed his efforts to find out more about Missouri’s unsuccessful bid to lure Boeing’s 777X to Missouri.

Key provisions of the Affordable Care Act go into effect at midnight and health-care coverage will begin for millions of Americans.

Yet because some states declined to expand Medicaid, there is a coverage gap for 5 million others, including more than 193,000 in Missouri.

As part of the federal Affordable Care Act, those with incomes between 100 and 400 percent of federal poverty levels will be eligible for financial assistance, or subsidies, as they purchase health insurance through the new marketplace.

U.S. Sen. Claire McCaskill, D-Mo., says she’ll go online within a week to sign up for health insurance on the federal exchange – but she won’t be taking the federal subsidy to help cover the cost.

“I’m not going to take the ‘employer contribution,’ “ McCaskill told Missouri reporters during a conference call Wednesday, referring to the federal government’s share of the health insurance premiums for all federal employees. She added that her staff will take the subsidy, as most other federal employees will do.

This article first appeared in the St. Louis Beacon. - The anticipated meeting next week between Gov. Jay Nixon and top legislative leaders, to discuss health care and Medicaid, may be on the ropes as a result of a dispute over how and where the session would proceed.

"At this point, the meeting has been cancelled,'' said state Sen. Gary Romine, R-Farmington, adding that he was taken aback by the governor's angry response to the legislators' conditions for the meeting.

A Missouri Senate interim committee examining the state's Medicaid system voted this afternoon to adopt a draft report that recommends using managed care companies to provide health coverage to more of Missouri's working poor.

The chair of a Missouri House interim committee on Medicaid has offered the beginnings of a potential plan to overhaul the system.

It includes expanding Medicaid coverage to around 225,000 adults while eliminating or reducing coverage for children and blind adults eligible for federally subsidized insurance policies. State Representative Jay Barnes (R, Jefferson City) says the potential changes could save the state around $42 million by the time they're fully implemented.

Nixon wants to meet Nov. 26 with members of House and Senate interim committees who have been studying potential Medicaid changes ahead of the 2014 session. The governor says he wants to talk about ways to "provide better outcomes for patients and better returns for taxpayers."

This article first appeared in the St. Louis Beacon: Much to the relief of health officials in the region, the federal government has decided to renew a waiver that guarantees continued health-care services to thousands of patients who signed up for Medicaid under a pilot program. Called Gateway to Better Health. The program has been offering primary, specialty and urgent care to more than 23,500 residents in St. Louis and St. Louis County.

This article first appeared in the St. Louis Beacon: With years of experience as a nurse and a nurse practitioner specializing in women’s health, Linda Spina has gained a lot of insight into why babies are born too soon, weigh too little, and, in some instances, die prematurely. She also has learned that conventional wisdom isn’t all it’s cracked up to be when it comes to saving at-risk newborns.

This article first appeared in the St. Louis Beacon: The reduction of health programs at ConnectCare will go beyond important specialty medical services and will extend to the crucial transportation network that has made it possible for some patients to get treatment at the site at 5535 Delmar Blvd.

Health planners said they will be scrambling to figure out which medical systems can provide specialty care to the more than 10,000 patients being displaced by ConnectCare’s decision. The planners promise to find transportation to alternative facilities.

A Missouri Senate interim committee looking into the state's Medicaid system heard from several doctors and other health care providers Wednesday at a hearing in Jefferson City.

Among those testifying was Thomas Hale, M.D., a St. Louis-based physician working with Sisters of Mercy. He told the panel that Medicaid needs to be expanded to make up for the pending loss of federal reimbursements to hospitals, known as DSH payments ("dish").